Give UTIs a fishy odor

Urogenital diseases in children

Children with urinary reflux (vesico-ureteral reflux, VUR) are particularly prone to urinary tract infections. In this congenital disorder, some urine flows back into the renal pelvis when the bladder is emptied. Children with congenital malformations of the urinary tract and small patients who suffer from chronic constipation or whose kidneys are scarred from previous infections also have an increased risk of infection.

 

The therapy is based on the age and severity of the VUR. In the first year of life, antibiotic prophylaxis usually takes place, especially with nitrofurantoin, trimethoprim and cephalosporins. Surgical (endoscopic) reflux correction or ureter reimplantation are indicated if the VUR persists beyond the first year of life or the child suffers breakthrough infections despite antibiotic prophylaxis.

 

Inflamed kidney corpuscles

 

In contrast to urinary tract infections, the cause of inflammation of the kidney corpuscles (glomeruli), known as glomerulonephritis, is mostly unknown. Sometimes it is caused by viruses or streptococci. The inflamed glomeruli can no longer perform their filter function properly; the amount of urine decreases, red blood cells and blood protein get into the urine. By contrast, waste products remain in the body.

 

With infectious glomerulonephritis, symptoms develop about a week after infection. Whatever the cause, the urine will be red, pink, or cloudy. The child passes less urine than usual and sometimes has headaches. Fluid can collect in the tissue. This leads to swelling, especially in the face and legs. In rare cases, blood pressure rises.

 

If glomerulonephritis is suspected, parents should immediately see their child to a doctor for a physical examination. A urine sample is analyzed, and fluid intake and excretion are measured. If the diagnosis is confirmed, the child will continue to be treated in the hospital. They usually get a special low-sodium and low-protein diet, and the fluid intake is adapted to the excretion. This relieves the kidneys and prevents fluid accumulation (edema formation).

 

If glomerulonephritis is bacterial, antibiotics are given. Increased blood pressure must be treated until the values ​​have normalized again.

 

If properly treated, the glomerulonephritis subsides within a week. Most often it does not cause permanent kidney damage and does not recur. Only very rarely can it result in chronic kidney damage, the so-called nephrotic syndrome, which requires long-term treatment (3). This term is used to summarize diseases that are characterized by edema, excessive renal protein excretion and hyperlipidemia (5).

 

Nephrotic Syndrome

 

Nephrotic syndrome can have very different causes. It can occur, for example, with visceral lupus erythematosus or Henoch-Schönlein purpura (toxic-allergic purpura) or it can be the result of an infectious disease. Intoxication, for example with penicillamine, can also trigger a nephrotic syndrome.

 

The disease is rather rare in childhood. About 10 to 25 in 1 million children under the age of 16 are affected, especially young children. Spontaneous remission rarely occurs. Rapid, optimal therapy is therefore necessary to protect children from acute complications and long-term consequential damage (6). Therefore, one should know the main symptoms of nephrotic syndrome:

 

Proteinuria,

decreased plasma and serum protein levels,

Elimination of small amounts of urine,

Edema in certain parts of the body, for example the eyelid, abdomen and ankle, which develops over several weeks,

Hyperlipidemia,

Weight gain as well

sometimes diarrhea, loss of appetite, and unusual tiredness.

 

If swelling occurs on a child's body, parents should take them to a doctor as soon as possible. This determines whether there is protein in the urine. If further findings such as hypoproteinemia, hypercholesterolemia and edema suggest a nephrotic syndrome, additional examinations will follow in the hospital. If the diagnosis is confirmed, the child will continue to be treated there.